1998 Fiscal Year Final Research Report Summary
Development of a less invasive and more simple interventional method to eliminate strial fibrillation and maintein the sinus rhythm.based on the mechanism of atrial fibrillation
| Project/Area Number |
09671391
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Thoracic surgery
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| Research Institution | Iwate Medical University |
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Principal Investigator |
CHIBA Naoki Iwate Medical University The Second Department of Medicine, Instructor, 医学部, 助手 (80254754)
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| Co-Investigator(Kenkyū-buntansha) |
SEGAWA Ikuo Iwate Medical University The Second Department of Medicine, Assistant Professor, 医学部, 講師 (50206611)
NASU Masataka Iwate Medical University The Second Department of Medicine, Assistant Professor, 医学部, 講師 (20180531)
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| Project Period (FY) |
1997 – 1998
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| Keywords | atrial fibrillation / maze operation / ablation / pulmonary vein / epicardial mapping / body surface mapping / electrocardiogram / impulse propagation |
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| Research Abstract |
The mechanism of origin, occurrence and maintenance of atrial fibrillation is still unclear. The maze procedure was curative with successful sinus rhythm restoration in 70 to 80% of the patients. However, we noted poor restoration of atrial mechanical transport function due to atrial pathological changes, multiple atriotomies or cryoadhesion. It is important to elucidate the mechanism of atrial fibrillation and to develop a less invasive and a more simple interventional method based on the mechanisms of atrial fibrillation.
First, intraoperative computerized activation mapping was analyzed in patients with chronic atrial fibrillation combined with isolated mitral disease in 1998. The results suggest that the mechanism of atrial fibrillation might be a simple macroreentry, and so a simple atrial fibrillation ablation may be possible in mitral disease. The previous head investigator, Yoko Yagi has developed a simple surgical ablation method consisting of only isolation of pulmonary veins, an interruption between the pulmonary veinsl. isolation line and the mitral annulus and an isthmus cryoablation alone in the right atrium in 1997. Twelve patients underwent treatment by this new method and analyzed the results in 1997.
Following the above study, we compared the diameters of pulmonary veins in patients with atrial fibrillation to those with normal sinus rhythm in 1998. The pulmonary vein orifaces in atrial fibrillation cases were larger than those in normal sinus rhythm cases. Now, we have clinically followed the most simple method consisting of pulmonary veins isolation alone.
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